Suctioning flexible ureteroscopic lithotripsy in the oblique supine lithotomy position and supine lithotomy position: a comparative retrospective study.

Abstract

Flexible ureteroscopy is very valuable for treating upper urinary tract calculi. However, no report has yet compared the clinical outcomes of flexible ureteroscopy performed on patients in different body positions. Therefore, we compared the safety and efficacy of suctioning flexible ureteroscopic lithotripsy with automatic control of renal pelvic pressure in the oblique supine lithotomy position and supine lithotomy position. A total of 82 patients with kidney calculi performed by suctioning flexible ureteroscopic lithotripsy with automatic control of renal pelvic pressure were retrospectively analyzed in single center. Group 1 included 47 patients treated via suctioning flexible ureteroscopy in the oblique supine lithotomy position. Group 2 included 35 patients treated in the supine lithotomy position. There were no significant differences in age, gender, or comorbidity rate between the two groups before surgery (P>0.05). Operative time, stone-free rate at postoperative day 30, renal pelvic pressure, postoperative complications, and length of hospital stay were compared between the two groups. Flexible ureteroscopy was successful after the first surgery in 73 patients and successful in the other nine patients after the placement of an indwelling double-J stent for 2 weeks. Compared to group 2, a significantly greater stone-free rate on postoperative day 30 and a significantly shorter operative time were noted in the group 2 (85.7% vs. 97.9%; 31.81±2.2 min vs. 23.4±14.9 min, P<0.05). We found no between-group difference in complication rates of Clavien grade I or Clavien grade II, renal pelvic pressure, and length of hospital stay (all P>0.05). Suctioning flexible ureteroscopic lithotripsy with automatic control of renal pelvic pressure in the oblique supine lithotomy position was safe and more effective than in the supine lithotomy position.